According to wind statistics, the net inflow of funds in the past two days was 28,936790,000 yuan, Tianhong Hang Seng Shanghai-Shenzhen-Hong Kong Innovative Drug Select 50 ETF (517380) has a net inflow of 464 in the past two days680,000 yuan, with a net inflow of 704 in the past five days020,000 yuan, favored by ** funds. As of 10:17 on December 11, the intraday trading volume of the ** was 3.65 million yuan, nearly 20% of the commission.
On December 14, the Federal Reserve will hold an interest rate meeting and announce its interest rate decision. According to the CME's "Fed Watch", the Fed maintained interest rates at 5 in December25%-5.The probability that the 50% interval will not change is 975%, with a 25 basis point rate hike of 25%。The probability of keeping interest rates unchanged by February next year is 838%, and the probability of a cumulative rate cut of 25 basis points is 141%。The valuation level of the pharmaceutical sector, especially the Hong Kong stock pharmaceutical sector, is sensitive to changes in the macro environment, and the improvement of the macro environment will help the overall valuation rise.
On December 8, Chi-Med's innovative drug production base, which took three years to build as a major strategic emerging industry project in Shanghai, announced that it had officially completed the construction of its innovative drug production base in Pudong. After completion, HUTCHMED's innovative drug production base covers an area of 43 acres, with a construction area of nearly 550,000 square meters, with an annual production capacity of 2 tablets500 million tablets, 5 capsules500 million capsules, in line with the international and domestic GMP standards of green and digital transformation intelligent requirements, will be built into China's first-class, global manufacturing center and clinical sample preparation center, support local innovation, support industrialization, support MAH commission, support global drug supply, so that more original innovative drugs from Shanghai to the world.
On December 8, the Zhejiang Provincial Medical Insurance Bureau issued a notice on publicly soliciting opinions and suggestions on the "Zhejiang Province Innovative Medical Technology Medical Insurance Payment Incentive Management Measures (Trial) (Draft for Comments)".The province will encourage the development of innovative drugs, medical devices and other fields through DRG incentives, and use medical insurance leverage to stimulate innovation. From the perspective of incentives, it is mainly through DRG payment points. This incentive policy creates a similar "green channel" for eligible products, so that innovative, but high-quality drugs and medical devices can remove barriers to the introduction and use of hospitals.
Medical insurance payment continues to explore and promote innovation in clinical practice
Since the beginning of China's drug policy reform in 2015, the competitive environment of domestic innovative drugs has become more open, and the competition mode has shifted from the commercial promotion of the back-end to the front-end target, point selection, clinical development and other links, and the competition of innovative drugs has become more fierce and all-round.
After several years of exploration and mechanism improvement, the national medical insurance talks no longer pursue the result of "big price reduction", and the rules and requirements have been adjusted in fluctuations and become more stable and acceptable, which means that the medical insurance negotiations have gradually had a relatively relaxed atmosphere and environment, which can allow innovative pharmaceutical companies to find opportunities in the dynamic balance and achieve a win-win situation for patients, medical insurance and enterprises. The medical insurance supports innovation with a clear banner, and innovative drugs "should be fully matched", breaking through the restrictions on the proportion of drugs and the amount of medical insurance, and opening up the "last mile" of hospital admission has become the core support point of many policies.
According to the deployment of the country, before 2025, all the inpatient departments of public medical institutions in the country must be paid and settled through DRG or DIP.
In the process of increasing demand for patients to "treat patients well" and the continuous increase in the innovation demands of medical institutions, there have been some collisions between the clinical implementation of innovative applications and the payment reform of DRG DIP. According to the research results of Liao Zangyi, an associate professor at the School of Politics and Public Administration of China University of Political Science and Law, local medical insurance departments have mainly explored the following four ways to promote the timely implementation of innovative applications in clinical practice without destroying the overall rules of DRG DIP payment.
First, carry out weight negotiations. In the DRG DIP payment model, the core of determining the amount of medical insurance payment is the weight of the disease group, and the larger the weight, the higher the payment amount, and the greater the space for innovative applications. In the process of forming the package fee of the disease group, some local medical insurance departments invite medical institution managers and clinicians to participate in the weight calculation process, and increase the weight of the disease group related to key disciplines and with large clinical innovation space through negotiation to help them obtain a higher payment amount.
Second, conduct a single discussion on special diseases. When the actual cost of using the innovative application exceeds the package fee, the case constitutes a "loss case", and the medical institution can then submit a special disease single application to the local medical insurance agency for it. After the medical insurance handling department organizes expert review and unanimous approval, the case will be exempted from payment, and the relevant expenses will be paid according to the project. This method is highly operable and is a common practice in various places.
Third, set the discipline adjustment coefficient. Some local medical insurance departments have added adjustment coefficients for key disciplines and disadvantaged disciplines, so that the disease groups associated with related disciplines can obtain a higher payment amount on the basis of standard payment. For example, Nanjing has established a dynamic management mechanism for the discipline coefficient of key disease groups, and for medical institutions undertaking national emergency medical rescue projects, academic coefficients of 104；For medical institutions with important academic status at home and abroad, and the leading units of the winners of the second prize or above of the National Science and Technology Progress Award, the frontier coefficient of 1 is assigned to their key disease groups04；The TCM disease group was given a TCM coefficient, and according to the increase in the proportion of TCM-based ** discharged patients, the TCM DRG disease group was assigned to the TCM DRG disease group. 03 TCM coefficient.
Fourth, implement a temporary exclusion policy. The data base for DRG DIP payments is the actual cost incurred for all cases over the past three years. However, for some innovative applications, because there is no historical accumulation data of the group, it cannot be included in the corresponding disease group to implement DRG DIP payment. To this end, the medical insurance department has proposed a temporary exclusion policy, that is, such innovative applications are temporarily stripped out, and the relevant expenses are paid according to the project;When the data accumulation is mature and the grouping conditions are met, the corresponding disease group will be included in the DRG DIP payment.
Debang ** believes that "Building a New Pattern of Pharmaceutical Governance and Jointly Achieving High-quality Pharmaceutical Innovation" clearly releases that the National Health Insurance Bureau is exploring new rules for the listing and pricing of innovative drugs, among which the "Guidelines for the Formation of New Coronary Drugs" may be the vane of the National Health Insurance Bureau in exploring new rules for listing pricing. This shows that the NHSA pays more attention to the balance between medical insurance cost control and encouraging the development of the biopharmaceutical industry, which is expected to drive the enthusiasm for innovative drug investment. The impact of anti-corruption may have passed, and the pharmaceutical industry may be evolving from large varieties (including ** drugs) to innovative drugs, and then to the core assets of medicine.
Tianhong Hang Seng Shanghai-Shenzhen-Hong Kong Innovative Drugs Select 50 ETF (517380)**Manager He Yuxuan:By strict definition, innovative drugs themselves will not be affected by centralized procurement. At present, there has been a similar centralized procurement in the field of innovative drugs, and the only single target is PD-1, because of its large number of listings and fierce competition. From the perspective of the people, the Health Insurance Bureau has the need and willingness to press down on drugs**, but it has an attitude of policy support for innovative drugs as a whole, and has long-term positive guidance. At the end of November this year, the medical insurance negotiations for innovative drugs have been implemented, and the overall feedback is relatively easy. You can also pay attention to the Hang Seng Shanghai-Shenzhen-Hong Kong Innovative Drugs Select 50 ETF (517380) and its link**A(014564) C(014565).
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